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Home My WebLink About23-7394 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-7394 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4900 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#TRIBAL OF 03 OBJECT 1 1 8 28 UNITS RESERVATION I I STRUCK z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 06 - 1-- 2023 1757 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ GARDEN AVENUE NORTH BLOCK ST e✓ MILEPOST 1100 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 40 00 FEET e S ❑B E e NORTH SOUTH PORT DR.❑ 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO F,/ I D:2068561525 0 81 30 6� LAST NAME BAMBAKH FIRSTNAME SNEZHANA MIDDLE N 1 1 2 31 INITIAL STREET ❑ 12117179TH AVENUE SE CITY RENTON ST WA 2jp, 98059 z NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10❑ Pi aT�S� CFH8364 sTATe WAvIN# 1GYKNDRS6HZ273662 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM TO TRLR. TRLR. $ 1 33 12 2 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34 13 D OW CADI XTS UT DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO SNEZHANA BAMBAKH 11117179TH AVENUE SE RENTONWA98059 D:2068561525 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 934137365 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLYYES NO CITATION# 3A0007694 INATTENTION <1�3 orrom 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:20 16 a 65499998 LAST NAME GAI FIRST NAME ADAM MIDDLE IN INITIAL 17❑ STREET ❑', 250204 5TH PL S F-105 CITY' KENT ST WA ZIP 98032 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l NO❑ 19 DRIVER'S STATE WA SEX M D.C... 02 _ 05 _ 1984 El 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE BKM5768 TATe WA VIN# 2TIBURHEOHC821683 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. N#. 43 RLR 'I VEH YEAR 2017 MAKE TOy7- MODEL COROLL STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO ADAM GAI 2502045TH PL S F-105 KENT WA 98032 D:2065499998 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU PORGY#E CO ALLSTATE 817-044-139IN 1 9TOP VEHICLE CITATION# CHARGE i o BOTTOM LEGALLY YES NC[:] 25❑ J s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 E.SAG/AO 10339 WA0171300 PAGE 01 OF PART A 3000-345-159 fR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED80075 COLLISION REPORT III III III III III 111 1591972 CASE# 23-7394 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) WILLIAMS JOYCELYN J (I.P.ST FIRST, ADDRESS&PHONE# 1133 LAKE WASH BLVD N F308 RENTON WA 98056 3474074368 SEX i U MMDDYyry 07 - 16 - 1964 {� SEAT HELMET INJURY NATURE OF INJURIES PASSENGER ZWITNESS❑ UNIT# 2 POS 9 AIRBAG 2 RESTR. q EJECT 1 USE CLASS '6 FROMREARlMPACT NAME '(LASTr FIR9'�MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYV PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS R PHONE# SEX D.O.B. MMDDYYYY. PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' On 6-29-23 at 1757 hours I was dispatched to a collision in the 1100 block of Garden Avenue North, in the City of Renton, King County, State of Washington. There were three vehicles involved. I arrived and contacted Unit#1 which was a white Cadillac XT5 (WA-CFH8364). I identified the driver by her Washington driver's license and owner, Snezhana Bambakh. She relayed that she was pulling up behind traffic and her foot slipped and she struck the vehicle in front of her. There were no reported injuries Unit#2 was a white 2017 Toyota Corolla (WA-BKM5768). It was driven by the owner, Adam Gai who I also identified by his Washington State license. Gai told me he was stopped at the light behind another vehicle facing northbound when Unit#1 struck his vehicle pushing it into a third vehicle. The passenger in the vehicle who sat in the back was Gai's mother who complained of pain but did not want aid. Her name was Joycelyn Williams. The third unit had left the scene but exchanged information with Unit#2 which he provided to me. Unit#3 was a 2013 Toyota Prius (WA-CFU7497). I spoke with the driver over the telephone who provided her name, Tatyana Movchan. She relayed her vehicle did not have any damage and did not complain of any injuries. She told me that the vehicle behind Unit#2 collided with his vehicle and her vehicle did not sustain damage. Damage viewed was consistent with accounts provide. I advised Unit#1 she would receive a citation for inattention through Renton court. I certify or declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. E.Sagiao/10339 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. E.SAGIAO 06-29-23 07:33 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 711612023 2:33:55 PM BADGE OR ID# 10339 OR]# WA0171300 TIME POLICE DISPATCHED! 5:57 PM TIME POLICE ARRIVED';6:02 PM PART Ei PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. ED80075 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-7394 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GI NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES NO D:4257371073 rFO 8 29 LAST NAME MOVCHAN FIRST NAME TATYANA MIDDLE V INITIAL STREET 30 NEW AnDRFSP 20703 CIRCLE BLUFF DR CITY ARLINGTON ST WA ZIP 1 98223 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES�NO� YEs N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 07 - 29 - 1982 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE CFU7497 TAr WA VIN# JTDKN3DU4D1631911 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.It VIN.#. 11 2 5 VEH.YEAR2013 MAKE TOYT MODELPRIUS STYLE SD VEHICLE TOWS E T SABLIN TOWED BY anvi vEH11' P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOEVGENY BOKSER 600 SW 5TH COURT E-303 RENTONWA98057 J 9 33 12 � SHADE IN DAMAGED AREA 7 j FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 967625584 q"i"Olx IN EFFECT I POLICY# 1 EwcLE 34 13 3 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTUM STANDING } 8 7 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ STREET 16 NEW ETET".� CITY ST ZIP AnnRCDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YES NO YES NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE ICLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv STANDING S 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. E,SAGIAO 06-29-23 07:33 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY CAT E 26 ORID# 10339 O#I',WA0171300 SCOTT 7/16/2023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED80075 CASE# ' 23-7394 DATE AND TIME 06/29/23 17:57 OF COLLISION North Southport Drive 1100 block of Garden Avenue North PAGE 4 OF 4